The relevance of tick bites to the production of IgE antibodies to the mammalian oligosaccharide galactose-α-1,3-galactose

doi:10.1016/J.JACI.2011.02.019

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The relevance of tick bites to the production of IgE antibodies to the mammalian oligosaccharide galactose-α-1,3-galactose

Journal Article•DOI•

The relevance of tick bites to the production of IgE antibodies to the mammalian oligosaccharide galactose-α-1,3-galactose

Scott P. Commins¹, Hayley James¹, Libby A. Kelly¹, S.L. Pochan¹, Lisa J. Workman¹, Matthew S. Perzanowski², Katherine M. Kocan³, John V. Fahy⁴, Lucy Ng’ang’a⁵, Eva Rönmark⁶, Philip J. Cooper⁷, Philip J. Cooper⁸, Thomas A.E. Platts-Mills¹ - Show less +9 more•Institutions (8)

University of Virginia Health System¹, Columbia University², Oklahoma State University–Stillwater³, University of California, San Francisco⁴, Kenya Medical Research Institute⁵, Umeå University⁶, Liverpool School of Tropical Medicine⁷, Universidad San Francisco de Quito⁸

01 May 2011-The Journal of Allergy and Clinical Immunology (J Allergy Clin Immunol)-Vol. 127, Iss: 5, pp 1286-1293

TL;DR: Evidence is provided that tick bites are a cause, possibly the only cause, of IgE specific for alpha-gal in this area of the United States, and the first example of a response to an ectoparasite giving rise to an important form of food allergy is reported.

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Abstract: Background: In 2009, we reported a novel form of delayed anaphylaxis to red meat that is related to serum IgE antibodies to the oligosaccharide galactose-alpha-1,3-galactose (alpha-gal). Most of th ...

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Journal Article•DOI•

Biological Roles of Glycans

[...]

Ajit Varki¹•Institutions (1)

University of California, San Diego¹

01 Jan 2017-Glycobiology

TL;DR: It is time for the diverse functional roles of glycans to be fully incorporated into the mainstream of biological sciences, as they are no different from other major macromolecular building blocks of life, simply more rapidly evolving and complex.

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Abstract: Simple and complex carbohydrates (glycans) have long been known to play major metabolic, structural and physical roles in biological systems. Targeted microbial binding to host glycans has also been studied for decades. But such biological roles can only explain some of the remarkable complexity and organismal diversity of glycans in nature. Reviewing the subject about two decades ago, one could find very few clear-cut instances of glycan-recognition-specific biological roles of glycans that were of intrinsic value to the organism expressing them. In striking contrast there is now a profusion of examples, such that this updated review cannot be comprehensive. Instead, a historical overview is presented, broad principles outlined and a few examples cited, representing diverse types of roles, mediated by various glycan classes, in different evolutionary lineages. What remains unchanged is the fact that while all theories regarding biological roles of glycans are supported by compelling evidence, exceptions to each can be found. In retrospect, this is not surprising. Complex and diverse glycans appear to be ubiquitous to all cells in nature, and essential to all life forms. Thus, >3 billion years of evolution consistently generated organisms that use these molecules for many key biological roles, even while sometimes coopting them for minor functions. In this respect, glycans are no different from other major macromolecular building blocks of life (nucleic acids, proteins and lipids), simply more rapidly evolving and complex. It is time for the diverse functional roles of glycans to be fully incorporated into the mainstream of biological sciences.

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1,588 citations

Journal Article•

Cetuximab Monotherapy and Cetuximab plus Irinotecan in Irinotecan-Refractory Metastatic Colorectal Cancer

[...]

Zhang Hua¹•Institutions (1)

Academy of Military Medical Sciences¹

01 Jan 2006-Journal of Evidence-based Medicine

1,139 citations

Journal Article•DOI•

Food allergy: a practice parameter update-2014.

[...]

Hugh A. Sampson¹, Seema S. Aceves², S. Allan Bock³, John M. James, Stacie M. Jones⁴, David M. Lang⁵, Kari C. Nadeau⁶, Anna Nowak-Wegrzyn¹, John Oppenheimer, Tamara T. Perry⁴, Christopher Randolph⁷, Scott H. Sicherer¹, Ronald A. Simon⁸, Brian P. Vickery⁹, Robert J. Wood¹⁰, David I. Bernstein¹¹, Joann Blessing-Moore⁶, David A. Khan¹², Richard A. Nicklas¹³, Jay M. Portnoy¹⁴, Diane E. Schuller¹⁵, Sheldon L. Spector¹⁶, Stephen A. Tilles¹⁷, Dana Wallace¹⁸ - Show less +20 more•Institutions (18)

Icahn School of Medicine at Mount Sinai¹, University of California, San Diego², University of Colorado Denver³, University of Arkansas for Medical Sciences⁴, Cleveland Clinic⁵, Stanford University⁶, Yale University⁷, Scripps Research Institute⁸, University of North Carolina at Chapel Hill⁹, Johns Hopkins University¹⁰, University of Cincinnati¹¹, University of Texas Southwestern Medical Center¹², George Washington University¹³, University of Missouri–Kansas City¹⁴, Pennsylvania State University¹⁵, University of California, Los Angeles¹⁶, University of Washington¹⁷, Nova Southeastern University¹⁸

01 Nov 2014-The Journal of Allergy and Clinical Immunology

TL;DR: This parameter was developed by the Joint Task Force on Practice Parameters, representing the American Academy of Allergy, Asthma & Immunology (AAAAI), the American College of Allerg, Acetiology & Infectious Diseases (ACAAI); and the Joint Council of Allergic, Aceto-Allergy, Immunology and Immunology(JCAAI) as discussed by the authors.

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Abstract: This parameter was developed by the Joint Task Force on Practice Parameters, representing the American Academy of Allergy, Asthma & Immunology (AAAAI); the American College of Allergy, Asthma & Immunology (ACAAI); and the Joint Council of Allergy, Asthma & Immunology (JCAAI). The AAAAI and the ACAAI have jointly accepted responsibility for establishing "Food Allergy: A practice parameter update—2014." This is a complete and comprehensive document at the current time. The medical environment is a changing one, and not all recommendations will be appropriate for all patients. Because this document incorporated the efforts of many participants, no single individual, including those who served on the Joint Task Force, is authorized to provide an official AAAAI or ACAAI interpretation of these practice parameters. Any request for information about or an interpretation of these practice parameters by the AAAAI or ACAAI should be directed to the Executive Offices of the AAAAI, ACAAI, and JCAAI. These parameters are not designed for use by pharmaceutical companies in drug promotion.

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612 citations

Journal Article•DOI•

EAACI Molecular Allergology User's Guide.

[...]

Paolo Maria Matricardi¹, Jörg Kleine-Tebbe, Hans Jürgen Hoffmann², Rudolf Valenta³, Christiane Hilger, Stephanie Hofmaier¹, Rob C. Aalberse⁴, Ioana Agache⁵, Riccardo Asero, Barbara Ballmer-Weber⁶, Domingo Barber, Kirsten Beyer¹, Tilo Biedermann⁷, M. B. Bilò, Simon Blank⁷, Barbara Bohle³, Philipp P. Bosshard⁶, Heimo Breiteneder³, Helen A. Brough⁸, Luis Caraballo⁹, J-C Caubet, Reto Crameri¹⁰, Janet M. Davies¹¹, Nikolaos Douladiris, M. Ebisawa, Philippe Eigenmann, Montserrat Fernandez-Rivas¹², Fatima Ferreira¹³, Gabriele Gadermaier¹³, Martin Glatz⁶, Robert G. Hamilton¹⁴, Thomas Hawranek, P W Hellings¹⁵, Karin Hoffmann-Sommergruber³, Thilo Jakob¹⁶, Uta Jappe¹⁷, Marek Jutel¹⁸, Sandip D. Kamath¹⁹, Edward F. Knol²⁰, Peter Korošec, Annette Kuehn, Gideon Lack⁸, Gideon Lack²¹, Andreas L. Lopata¹⁸, Mika J. Mäkelä²², Martine Morisset²³, Verena Niederberger³, Anna Nowak-Wegrzyn²⁴, Nikolaos G. Papadopoulos²⁵, Elide A. Pastorello, Gabrielle Pauli, Thomas A.E. Platts-Mills²⁶, Daniela Posa¹, Lars K. Poulsen²⁷, Monika Raulf²⁸, Joaquín Sastre, Enrico Scala, Johannes Schmid², Peter Schmid-Grendelmeier⁶, M. van Hage²⁹, R. van Ree⁴, Stefan Vieths³⁰, Richard W. Weber³¹, Magnus Wickman³², Antonella Muraro³³, Markus Ollert³⁴ - Show less +62 more•Institutions (34)

Charité¹, Aarhus University Hospital², Medical University of Vienna³, University of Amsterdam⁴, Transylvania University⁵, University of Zurich⁶, Technische Universität München⁷, King's College London⁸, University of Cartagena⁹, Swiss Institute of Allergy and Asthma Research¹⁰, Queensland University of Technology¹¹, Hospital Clínico San Carlos¹², University of Salzburg¹³, Johns Hopkins University School of Medicine¹⁴, Katholieke Universiteit Leuven¹⁵, University of Giessen¹⁶, University of Lübeck¹⁷, Wrocław Medical University¹⁸, Australian Institute of Tropical Health and Medicine¹⁹, Utrecht University²⁰, Guy's and St Thomas' NHS Foundation Trust²¹, Helsinki University Central Hospital²², Centre Hospitalier de Luxembourg²³, Icahn School of Medicine at Mount Sinai²⁴, University of Manchester²⁵, University of Virginia²⁶, Copenhagen University Hospital²⁷, Ruhr University Bochum²⁸, Karolinska University Hospital²⁹, Paul Ehrlich Institute³⁰, University of Colorado Denver³¹, Boston Children's Hospital³², University of Padua³³, University of Southern Denmark³⁴

01 May 2016-Pediatric Allergy and Immunology

TL;DR: The European Academy of Allergy and Clinical Immunology (EAACI) Molecular Allergology User's Guide (MAUG) as mentioned in this paper provides comprehensive information on important allergens and describes the diagnostic options using component-resolved diagnosis (CRD).

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Abstract: The availability of allergen molecules ('components') from several protein families has advanced our understanding of immunoglobulin E (IgE)-mediated responses and enabled 'component-resolved diagnosis' (CRD). The European Academy of Allergy and Clinical Immunology (EAACI) Molecular Allergology User's Guide (MAUG) provides comprehensive information on important allergens and describes the diagnostic options using CRD. Part A of the EAACI MAUG introduces allergen molecules, families, composition of extracts, databases, and diagnostic IgE, skin, and basophil tests. Singleplex and multiplex IgE assays with components improve both sensitivity for low-abundance allergens and analytical specificity; IgE to individual allergens can yield information on clinical risks and distinguish cross-reactivity from true primary sensitization. Part B discusses the clinical and molecular aspects of IgE-mediated allergies to foods (including nuts, seeds, legumes, fruits, vegetables, cereal grains, milk, egg, meat, fish, and shellfish), inhalants (pollen, mold spores, mites, and animal dander), and Hymenoptera venom. Diagnostic algorithms and short case histories provide useful information for the clinical workup of allergic individuals targeted for CRD. Part C covers protein families containing ubiquitous, highly cross-reactive panallergens from plant (lipid transfer proteins, polcalcins, PR-10, profilins) and animal sources (lipocalins, parvalbumins, serum albumins, tropomyosins) and explains their diagnostic and clinical utility. Part D lists 100 important allergen molecules. In conclusion, IgE-mediated reactions and allergic diseases, including allergic rhinoconjunctivitis, asthma, food reactions, and insect sting reactions, are discussed from a novel molecular perspective. The EAACI MAUG documents the rapid progression of molecular allergology from basic research to its integration into clinical practice, a quantum leap in the management of allergic patients.

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558 citations

Journal Article•DOI•

A WAO - ARIA - GA²LEN consensus document on molecular-based allergy diagnostics.

[...]

Giorgio Walter Canonica¹, Ignacio J. Ansotegui, Ruby Pawankar², Peter Schmid-Grendelmeier³, Marianne van Hage⁴, Carlos E. Baena-Cagnani⁵, Giovanni Melioli⁶, Carlos Nunes, Giovanni Passalacqua¹, Lanny J. Rosenwasser⁷, Hugh A. Sampson⁸, Joaquín Sastre⁹, Jean Bousquet, Torsten Zuberbier¹⁰ - Show less +10 more•Institutions (10)

University of Genoa¹, Nippon Medical School², University of Zurich³, Karolinska Institutet⁴, The Catholic University of America⁵, Istituto Giannina Gaslini⁶, University of Missouri–Kansas City⁷, Icahn School of Medicine at Mount Sinai⁸, Autonomous University of Madrid⁹, Charité¹⁰

03 Oct 2013-World Allergy Organization Journal

TL;DR: The aim of this consensus document is to provide a practical guide for the indications, determination, and interpretation of MA diagnostics for clinicians trained in allergology.

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371 citations

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Journal Article•DOI•

Radiotherapy plus Cetuximab for Squamous-Cell Carcinoma of the Head and Neck

[...]

James A. Bonner¹, Paul M. Harari², Jordi Giralt³, Nozar Azarnia⁴, Dong M. Shin⁵, Roger B. Cohen⁶, Christopher U. Jones, Ranjan Sur⁷, David Raben⁸, Jacek Jassem⁹, Roger Ove¹⁰, Merrill S. Kies, José Baselga³, Hagop Youssoufian⁴, Nadia Amellal¹¹, Eric K. Rowinsky¹², Eric K. Rowinsky⁴, K. Kian Ang - Show less +14 more•Institutions (12)

University of Alabama at Birmingham¹, University of Wisconsin-Madison², Autonomous University of Barcelona³, Eli Lilly and Company⁴, University of Texas MD Anderson Cancer Center⁵, University of Virginia⁶, University of the Witwatersrand⁷, University of Colorado Boulder⁸, Gdańsk Medical University⁹, University of Alabama¹⁰, Merck KGaA¹¹, ImClone Systems¹²

09 Feb 2006-The New England Journal of Medicine

TL;DR: Treatment of locoregionally advanced head and neck cancer with concomitant high-dose radiotherapy plus cetuximab improves locoreGional control and reduces mortality without increasing the common toxic effects associated with radiotherapy to the head andneck.

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Abstract: BACKGROUND We conducted a multinational, randomized study to compare radiotherapy alone with radiotherapy plus cetuximab, a monoclonal antibody against the epidermal growth factor receptor, in the treatment of locoregionally advanced squamous-cell carcinoma of the head and neck. METHODS Patients with locoregionally advanced head and neck cancer were randomly assigned to treatment with high-dose radiotherapy alone (213 patients) or high-dose radiotherapy plus weekly cetuximab (211 patients) at an initial dose of 400 mg per square meter of body-surface area, followed by 250 mg per square meter weekly for the duration of radiotherapy. The primary end point was the duration of control of locoregional disease; secondary end points were overall survival, progression-free survival, the response rate, and safety. RESULTS The median duration of locoregional control was 24.4 months among patients treated with cetuximab plus radiotherapy and 14.9 months among those given radiotherapy alone (hazard ratio for locoregional progression or death, 0.68; P = 0.005). With a median follow-up of 54.0 months, the median duration of overall survival was 49.0 months among patients treated with combined therapy and 29.3 months among those treated with radiotherapy alone (hazard ratio for death, 0.74; P = 0.03). Radiotherapy plus cetuximab significantly prolonged progression-free survival (hazard ratio for disease progression or death, 0.70; P = 0.006). With the exception of acneiform rash and infusion reactions, the incidence of grade 3 or greater toxic effects, including mucositis, did not differ significantly between the two groups. CONCLUSIONS Treatment of locoregionally advanced head and neck cancer with concomitant highdose radiotherapy plus cetuximab improves locoregional control and reduces mortality without increasing the common toxic effects associated with radiotherapy to the head and neck. (ClinicalTrials.gov number, NCT00004227.)

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4,705 citations

"The relevance of tick bites to the ..." refers background in this paper

...The mAb cetuximab, which is specific for epidermal growth factor receptor, was approved for use in treating cancer in 2005.(1,2) Shortly thereafter, it became clear that a significant number of patients were experiencing severe hypersensitivity reactions during their first infusion of this mAb....
[...]

Journal Article•DOI•

Cetuximab monotherapy and cetuximab plus irinotecan in irinotecan-refractory metastatic colorectal cancer.

[...]

David Cunningham¹, Yves Humblet², Salvatore Siena, David Khayat³, Harry Bleiberg⁴, Armando Santoro, D. Bets⁵, M. Mueser⁶, Andreas Harstrick⁶, Chris Verslype⁷, Ian Chau¹, Eric Van Cutsem⁷ - Show less +8 more•Institutions (7)

The Royal Marsden NHS Foundation Trust¹, Université catholique de Louvain², University of Paris³, Université libre de Bruxelles⁴, Merck & Co.⁵, Merck KGaA⁶, Katholieke Universiteit Leuven⁷

22 Jul 2004-The New England Journal of Medicine

TL;DR: Cetuximab has clinically significant activity when given alone or in combination with irinotecan in patients with ir inotecans-refractory colorectal cancer.

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Abstract: background The epidermal growth factor receptor (EGFR), which participates in signaling pathways that are deregulated in cancer cells, commonly appears on colorectal-cancer cells. Cetuximab is a monoclonal antibody that specifically blocks the EGFR. We compared the efficacy of cetuximab in combination with irinotecan with that of cetuximab alone in metastatic colorectal cancer that was refractory to treatment with irinotecan. methods We randomly assigned 329 patients whose disease had progressed during or within three months after treatment with an irinotecan-based regimen to receive either cetuximab and irinotecan (at the same dose and schedule as in a prestudy regimen [218 patients]) or cetuximab monotherapy (111 patients). In cases of disease progression, the addition of irinotecan to cetuximab monotherapy was permitted. The patients were evaluated radiologically for tumor response and were also evaluated for the time to tumor progression, survival, and side effects of treatment. results The rate of response in the combination-therapy group was significantly higher than that in the monotherapy group (22.9 percent [95 percent confidence interval, 17.5 to 29.1 percent] vs. 10.8 percent [95 percent confidence interval, 5.7 to 18.1 percent], P=0.007). The median time to progression was significantly greater in the combination-therapy group (4.1 vs. 1.5 months, P<0.001 by the log-rank test). The median survival time was 8.6 months in the combination-therapy group and 6.9 months in the monotherapy group (P=0.48). Toxic effects were more frequent in the combinationtherapy group, but their severity and incidence were similar to those that would be expected with irinotecan alone. conclusions Cetuximab has clinically significant activity when given alone or in combination with irinotecan in patients with irinotecan-refractory colorectal cancer.

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4,625 citations

Immunol. Cell Biol.

[...]

Melinda Fitzgerald, Ian P. Hayward, Anita C Thomas, Julie H. Campbell, Gordon R. Campbell - Show less +1 more

01 Jan 1995

2,770 citations

Journal Article•DOI•

Cetuximab-Induced Anaphylaxis and IgE Specific for Galactose-α-1,3-Galactose

[...]

Christine H. Chung¹, Beloo Mirakhur², Emily Chan¹, Quynh-Thu Le³, Jordan Berlin¹, Michael A. Morse⁴, Barbara A. Murphy¹, S.M. Satinover⁵, Jacob D. Hosen⁵, David J. Mauro², Robbert J.C. Slebos¹, Qinwei Zhou⁶, Diane R. Gold⁷, Tina Hatley, Daniel J. Hicklin⁶, Thomas A.E. Platts-Mills⁵ - Show less +12 more•Institutions (7)

Vanderbilt University¹, Bristol-Myers Squibb², Stanford University³, Duke University⁴, University of Virginia⁵, ImClone Systems⁶, Harvard University⁷

13 Mar 2008-The New England Journal of Medicine

TL;DR: In most subjects who had a hypersensitivity reaction to cetuximab, IgE antibodies against cetUXimab were present in serum before therapy, and the antibodies were specific for galactose-alpha-1,3-galactose.

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Abstract: Background Cetuximab, a chimeric mouse–human IgG1 monoclonal antibody against the epidermal growth factor receptor, is approved for use in colorectal cancer and squamous-cell carcinoma of the head and neck. A high prevalence of hypersensitivity reactions to cetuximab has been reported in some areas of the United States. Methods We analyzed serum samples from four groups of subjects for IgE antibodies against cetuximab: pretreatment samples from 76 case subjects who had been treated with cetuximab at multiple centers, predominantly in Tennessee, Arkansas, and North Carolina; samples from 72 control subjects in Tennessee; samples from 49 control subjects with cancer in northern California; and samples from 341 female control subjects in Boston. Results Among 76 cetuximab-treated subjects, 25 had a hypersensitivity reaction to the drug. IgE antibodies against cetuximab were found in pretreatment samples from 17 of these subjects; only 1 of 51 subjects who did not have a hypersensitivity reaction had such ant...

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1,165 citations

"The relevance of tick bites to the ..." refers background or methods or result in this paper

...The Tennessee control cohort was obtained as a random control population in a cancer-screening clinic at Vanderbilt University.(5) The North Carolina cohort was collected randomly from hospital patients at the University of North Carolina as part of a study on the genetics of this anaphylactic response (unpublished data)....
[...]
...More importantly, the results led to the realization that IgE to alpha-gal was also associated with a novel form of food allergy.(5,9) Those patients reported that they had generalized urticaria or frank anaphylaxis starting 3 to 6 hours after eating beef, pork, or lamb; however, they reported tolerating chicken, turkey, or fish without difficulty....
[...]
...The Tennessee control cohort was obtained as a random control population in a cancer-screening clinic at Vanderbilt University.5 The North Carolina cohort was collected randomly from hospital patients at the University of North Carolina as part of a study on the genetics of this anaphylactic response.16 The Virginia patients included 70 with acute asthma and 66 controls presenting to the ED at the University of Virginia.17 In this last population, there was no difference in the prevalence of IgE to alpha-gal between the patients with asthma and the controls....
[...]
...Although ticks are ubiquitous in temperate and tropical regions, there are major regional differences in species and also regions or populations where tick bites are rare or absent (Table II).(5,9,16-22) These include large cities and areas where the climate prevents survival of ticks or their natural hosts (eg, deer and small mammals)....
[...]
...At that time, a detailed investigation of serum antibodies established that these reactions were occurring in patients who had preexisting IgE antibodies specific for the glycosylation on the Fab fragment of the mAb.(5) The relevant oligosaccharide is galactose-a-1,3-galactose (alpha-gal), which is a blood group substance of nonprimate mammals....
[...]

Journal Article•DOI•

Delayed anaphylaxis, angioedema, or urticaria after consumption of red meat in patients with IgE antibodies specific for galactose-α-1,3-galactose.

[...]

Scott P. Commins¹, S.M. Satinover¹, Jacob D. Hosen¹, J. Mozena, Larry Borish¹, Barrett D. Lewis, Judith A. Woodfolk¹, Thomas A.E. Platts-Mills¹ - Show less +4 more•Institutions (1)

University of Virginia Health System¹

01 Feb 2009-The Journal of Allergy and Clinical Immunology

TL;DR: A novel and severe food allergy related to IgE antibodies to the carbohydrate epitope alpha-gal is reported from patients who experience delayed symptoms of anaphylaxis, angioedema, or urticaria associated with eating beef, pork, or lamb.

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Abstract: Background Carbohydrate moieties are frequently encountered in food and can elicit IgE responses, the clinical significance of which has been unclear. Recent work, however, has shown that IgE antibodies to galactose-α-1,3-galactose (α-gal), a carbohydrate commonly expressed on nonprimate mammalian proteins, are capable of eliciting serious, even fatal, reactions. Objective We sought to determine whether IgE antibodies to α-gal are present in sera from patients who report anaphylaxis or urticaria after eating beef, pork, or lamb. Methods Detailed histories were taken from patients presenting to the University of Virginia Allergy Clinic. Skin prick tests (SPTs), intradermal skin tests, and serum IgE antibody analysis were performed for common indoor, outdoor, and food allergens. Results Twenty-four patients with IgE antibodies to α-gal were identified. These patients described a similar history of anaphylaxis or urticaria 3 to 6 hours after the ingestion of meat and reported fewer or no episodes when following an avoidance diet. SPTs to mammalian meat produced wheals of usually less than 4 mm, whereas intradermal or fresh-food SPTs provided larger and more consistent wheal responses. CAP-RAST testing revealed specific IgE antibodies to beef, pork, lamb, cow's milk, cat, and dog but not turkey, chicken, or fish. Absorption experiments indicated that this pattern of sensitivity was explained by an IgE antibody specific for α-gal. Conclusion We report a novel and severe food allergy related to IgE antibodies to the carbohydrate epitope α-gal. These patients experience delayed symptoms of anaphylaxis, angioedema, or urticaria associated with eating beef, pork, or lamb.

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555 citations

"The relevance of tick bites to the ..." refers background or result in this paper

...More importantly, the results led to the realization that IgE to alpha-gal was also associated with a novel form of food allergy.(5,9) Those patients reported that they had generalized urticaria or frank anaphylaxis starting 3 to 6 hours after eating beef, pork, or lamb; however, they reported tolerating chicken, turkey, or fish without difficulty....
[...]
...Although ticks are ubiquitous in temperate and tropical regions, there are major regional differences in species and also regions or populations where tick bites are rare or absent (Table II).(5,9,16-22) These include large cities and areas where the climate prevents survival of ticks or their natural hosts (eg, deer and small mammals)....
[...]
...!Patients presenting to the clinic with a history of recurrent anaphylaxis, angioedema, or generalized urticaria occurring 3 to 5 hours after eating mammalian meat.(9) "Patients evaluated in the University of Virginia Allergic Disease clinic for asthma,...
[...]
...Those patients reported that they had generalized urticaria or frank anaphylaxis starting 3 to 6 hours after eating beef, pork, or lamb; however, they reported tolerating chicken, turkey, or fish without difficulty.(9,10) Thus, the specificity of IgE antibodies present in their serum,whichwas known to be specific for a carbohydrate common to mammals but absent from poultry and fish, matched their symptoms....
[...]
...Thus, the specificity of IgE antibodies present in their serum,whichwas known to be specific for a carbohydrate common to mammals but absent from poultry and fish, matched their symptoms.(6,9) In most cases, these patients were adults who had consumed red meat for many years before having the delayed From the Asthma and Allergic Diseases Center, University of Virginia Health System, Charlottesville; Mailman School of Public Health, Columbia University, New York; the Center for Veterinary Health Sciences, Oklahoma State University, Stillwater; the Department of Medicine, University of California, San Francisco; the Center...
[...]